Real-world data and treatment patterns of patients with lower urinary tract symptoms due to benign prostatic hyperplasia in Germany: an observational study using health insurance claims data

Abstract

Purpose Benign prostatic hyperplasia (BPH) is associated with lower urinary tract symptoms (LUTS), representing one of the most common urological conditions. However, insights into the actual healthcare of this patient cohort in Germany are scarce. We aimed to retrospectively analyse management patterns of patients with LUTS in Germany using health insurance claims databases. Methods A retrospective, longitudinal cohort analysis was conducted obtaining claims data from the German InGef health insurance database containing approximately five million member-records from over 60 nationwide statutory health insurances. First, a cross-sectional prevalence analysis was performed on all individuals with a diagnosis on LUTS (ICD-10 GM N40) in 2018. Second, a longitudinal analysis of individuals with either a newly started BPH medication or initial BPH surgery who were indexed in 2014 and followed-up for 4 years. ResultsIn 2018, 132,386 (6.7%) prevalent BPH patients were identified from 1,979,916 continuously insured males. A potential overcoding bias could not be assessed which may influence the outpatient sector estimation. 10,361 (0.7%) patients were identified with incident BPH medication and 1768 (0.1%) patients with incident BPH surgery out of 1,575,604 males (2013)(2014)(2015)(2016)(2017)(2018). Alpha-blockers were the drug of choice (95.6%) in the first year. Half of patients received specific BPH medications four years after index, while almost 98% of initial BPH surgeries were performed within the inpatient setting. TURP was the most frequent surgical intervention (76%). Conclusions A widespread diffusion of alternative individualized minimally invasive approaches in the outpatient sector might address pharmacotherapy discontinuation and patient-access barriers to other treatments.

Clinical efficacy and complications of transurethral resection of the prostate versus plasmakinetic enucleation of the prostate

“…It is a common disease with lower urinary tract symptoms in middle-aged and elderly males, which is becoming more prevalent in parallel with the aging of demographic structures in China [ 1 ]. In recent years, the overall morbidity of elderly males was approximately 50%, and the prevalence of BPH is about 70% in men over 70 years old [ 2 – 4 ]. There are many medical and surgical treatment choices for BPH, such as medical drugs, traditional Chinese medicine, physiotherapeutic techniques, surgical approaches, and combination therapy [ 5 , 6 ].…”